NPI | 1063840619 |
---|---|
Former Name | TARYN HOUSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.010823) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209010823) |
363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209010823) | |
Enumeration Date | 2013-10-17 |
Last Update Date | 2022-03-25 |